Recent advances in the field of minimally invasive cardiac surgery have included the development of aortic catheters and methods for inducing cardioplegic arrest without the necessity of opening the patient's chest with a sternotomy or other major thoracotomy. For example, U.S. Pat. No. Re 35,352 to Peters describes a single balloon catheter for occluding a patient's ascending aorta and a method for inducing cardioplegic arrest. A perfusion lumen or a contralateral arterial cannula is provided for supplying oxygenated blood during cardiopulmonary bypass. U.S. Pat. No. 5,584,803 to Stevens et al. describes a single balloon catheter for inducing cardioplegic arrest and a system for providing cardiopulmonary support during closed chest cardiac surgery. A coaxial arterial cannula is provided for supplying oxygenated blood during cardiopulmonary bypass. The occlusion balloon of these catheters must be very carefully placed in the ascending aorta between the coronary arteries and the brachiocephalic artery, therefore the position of the catheter must be continuously monitored to avoid complications. In clinical use, these single balloon catheters have shown a tendency to migrate in the direction of the pressure gradient within the aorta. That is to say that, during infusion of cardioplegia, the balloon catheter will tend to migrate downstream due to the higher pressure on the upstream side of the balloon and, when the CPB pump is on, the balloon catheter with tend to migrate upstream into the aortic root due to the higher pressure on the downstream side of the balloon. This migration can be problematic if the balloon migrates far enough to occlude the brachiocephalic artery on the downstream side or the coronary arteries on the upstream side. PCT patent application WO 97/21462 by Fan et al. attempts to overcome this problem with a balloon catheter having high friction areas on the outer surface of the balloon. A problem with this single balloon approach is that a relatively large balloon is needed to create enough friction to avoid migration of the inflated balloon. The larger the balloon is, the more carefully it must be placed in the ascending aorta to avoid occluding the coronary arteries or the brachiocephalic artery and the less margin of error there is should any balloon migration occur.
U.S. Pat. No 5,312,344 to Grinfeld et al. describes an arterial perfusion cannula having two closely spaced balloons positioned in the ascending aorta. However, this patent does not provide any guidance on how to avoid migration or inadvertent occlusion of the coronary arteries or the brachiocephalic artery. It would be desirable to provide an aortic occlusion catheter for inducing cardioplegic arrest that minimizes the likelihood of migration of the balloon or occluding member in the ascending aorta.
Another important development in the area of aortic balloon catheters is the concept of selective aortic perfusion. U.S. Pat. Nos. 5,308,320, 5,383,854 and 5,820,593 by Peter Safar, S. William Stezoski and Miroslav Klain describe a double balloon catheter for segmenting a patient's aorta for selective perfusion of different organ systems within the body. Other U.S. patents which address the concept of selective aortic perfusion include U.S. Pat. Nos.; 5,738,649, 5,833,671 and 5,827,237 by John A. Macoviak; and Michael Ross and commonly owned, copending patent applications Ser. No.; 08/909,293 filed Aug. 11, 1997; and Ser. No. 08/909,380 filed Nov. 8, 1997, by Safar et al.; and Ser. No. 08/665,635, filed Jun. 18, 1996 by John A. Macoviak; and Michael Ross. These patent applications and all other patents referred to herein are hereby incorporated by reference in their entirety. Selective perfusion can be used to prioritize the flow of oxygenated blood or other protective fluids to the various organ systems, therefore achieving optimal preservation of all organ systems within the body. It would be desirable to include this feature of selective perfusion in an aortic occlusion catheter for inducing cardioplegic arrest.